title: Gemcitabine-related thrombotic microangiopathy: a single-centre retrospective series.
abstract: BACKGROUND
  Thrombotic microangiopathy (TMA) has been reported as a complication of chemotherapy. Many antineoplastic agents have been linked to TMA, gemcitabine being one of the most frequently cited as related to this syndrome.
  
  
  METHODS
  A retrospective search for chemotherapy-induced TMA cases among gemcitabine users in a single oncology centre from January 2009 to September 2012 was performed.
  
  
  RESULTS
  Three cases of gemcitabine-induced TMA were reported, from a total of 264 patients (incidence: 1·13%) who received the drug. From the three cases reported, two (66%) patients died as a consequence of the syndrome.
  
  
  CONCLUSIONS
  These findings are compatible with previous analyses, which report an incidence of gemcitabine-associated TMA ranging from 0·008 to 2·2% and mortality rates from 15 to 90%. Unlike previously reported, however, cumulative dose was not predictive of risk.
  
  
  CONCLUSIONS
  Gemcitabine-induced TMA is an underdiagnosed condition characterized by high mortality rates. Attention should be called for a higher level of awareness to provide early diagnosis and proper treatment.
authors.forename: Frederico
authors.initials: F
authors.lastname: Leal
authors.forename: Ligia T
authors.initials: LT
authors.lastname: Macedo
authors.forename: José Barreto C
authors.initials: JB
authors.lastname: Carvalheira
mesh_terms: D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D012189:Retrospective Studies; D057049:Thrombotic Microangiopathies / Q000139:chemically induced* / Q000453:epidemiology; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine
keywords: Chemotherapy,; Drug toxicity,; Gemcitabine,; Thrombotic microangiopathies; Thrombotic thrombocytopenic purpura,